Doctors who treated patients with infected blood worked for firms making it

Doctors who treated patients with infected blood products worked for the companies who made them, The Telegraph can disclose.

Leading NHS doctors consulted and did paid research for US pharmaceutical companies who manufactured a “miracle” treatment for haemophilia that was infected with HIV and hepatitis C.

New documents about the work of doctors in London, Newcastle and Hampshire raise questions of a conflict of interest between specialists and the pharmaceutical industry at a time when there was growing evidence of medication being contaminated with hepatitis and HIV.

In the 1970s and 1980s, 1,250 people with haemophilia contracted HIV after receiving a blood product called Factor VIII. As many as 5,000 more people were infected with hepatitis C from blood products, and up to 28,000 after receiving a blood transfusion.

Most of the HIV infections were caused by Factor VIII imported from the US, where pharmaceutical companies collected plasma from inmates, intravenous drug users, gay men and sex workers as the Aids crisis emerged. The UK didn’t make enough of its own Factor VIII, which allowed companies seeking profit to seize a bigger share of the market.

The Infected Blood Inquiry will release its report on May 20 into the biggest treatment disaster in NHS history in which some 3,000 people have died. Survivors and bereaved relatives are seeking compensation from the Government, an apology and answers about how the infections happened.

Admitted he was paid consultant

In the newly revealed meeting minutes from 1977, leading specialist Dr Peter Jones, director of Newcastle Haemophilia Centre, admitted he was a paid consultant for Baxter Healthcare’s Hyland Laboratories.

Dr Jones, who was too frail to give evidence to the Infected Blood Inquiry, offered to remove himself from a discussion about UK expansion of its own blood products manufacture amid fears that imported US Factor VIII was more likely to contain blood-borne viruses.

“Dr Jones declared his interest in this item as he was a paid consultant to Hyland Laboratories,” said the memo, shared exclusively with The Telegraph by campaign group Factor 8. “It was agreed that he could stay.”

Prof Edward Tuddenham, emeritus professor at the Royal Free in London, said the memo raised questions about a conflict of interest. “Dr Jones is sort of putting himself on the side of the company,” said Prof Tuddenham. “To Hyland it would not have been good for the UK to start making its own competitive product. It shows Dr Jones is an adviser to them and their company policy on producing factor concentrates.”

Jason Evans, director of the campaign group Factor 8, said: “This is years after the risks of hepatitis C have been raised.”

It was known in the 1970s that imported US Factor VIII was more likely to transmit hepatitis than the NHS-made version, because the US paid plasma donors, a practice illegal in the UK. When Aids emerged as a threat to people with haemophilia in 1982 it was clear the US was an epicentre.

Downplayed the risks

In 1983, after the first British people with haemophilia developed signs of Aids, Dr Jones downplayed the risks. In May he said: “We have absolutely no doubt at all that the benefits are far greater than the risk, if the risk is actually there.”

That same month, a letter reveals he still had an “interest”. Dr Frank Boulton from the NHS Blood and Transplant service wrote about Dr Jones: “I felt he was still being somewhat less than cautious in his attitude [towards Aids], but this is not unexpected given his interests etc.”

Dr Jones was one of the leading haemophilia advisers along with Prof Arthur Bloom, whose lack of caution over the Aids risk from US Factor VIII was followed by the UK government.

In 1984, Dr Peter Kernoff of the Royal Free Hospital in London told US Factor VIII maker Armour that “profound changes” to imports of Factor VIII could soon be needed because of the risk of Aids.

Armour offered Dr Kernoff a £12,396 grant (equivalent to £50,000 today) for the salary of a lab technician to research the connection between Aids and blood products, which he accepted.

At the Lord Mayor Treloar College, where 122 pupils were infected with HIV and hepatitis C, 75 of whom have died, the lead doctor Dr Anthony Aronstam wrote a book about haemophilia that Armour “generously contributed to the production costs of”.

Dr Geoffrey Savidge, director at St Thomas’ Hospital, was a paid consultant for pharmaceutical companies, who offered him thousands of pounds in rebates for buying their products.

Cosy relationships

Mr Evans said the cosy relationship between doctors and pharmaceutical companies was a national issue, but was more pronounced at some hospitals.

“It happened at every centre to differing degrees,” said Mr Evans. “Peter Jones may have been a paid consultant but others had sponsorship of their research and events. In some of the smaller haemophilia centres like Whitechapel in London, the pharmaceutical companies would pay for nurses to go to international conferences and pay for their travel and accommodation.”

Prof Tuddenham recalled lavish hospitality from pharmaceutical companies, including five-star trips to Istanbul and Paris.

“It’s down to the individual doctors’ moral judgment on whether or not you’re being influenced to do something you wouldn’t otherwise do,” he said, confirming that he was never swayed by pharmaceutical marketing.

Factor VIII manufacturers, including Baxter, Bayer and Armour, sponsored trips for medical staff and gifted branded goods to patients. One pupil recalls getting a watch branded by “Baxter” while at Lord Mayor Treloar College. The Infected Blood Inquiry heard from Armour marketeer Christopher Bishop that the company had a branding campaign with Mr Men.

“There was clearly a decision at Armour to target their paraphernalia at children,” said Mr Evans. “What’s more geared towards children than Mr Men? I’ve seen photos of Baxter teddy bears. That’s extremely sinister and disturbing. Specifically because these same people must have known the risks that were associated with their products.”

‘Going to crucify doctors’

Prof Liakat Parapia, former head of the haemophilia centre in Bradford, is concerned the Infected Blood Inquiry’s final report will be “hostile” towards doctors. “I think the report is going to crucify doctors,” he said. “The doctors were acting in the best interest of patients. They were under pressure from all sides.”

Doctors have been accused of not warning patients of the dangers of Factor VIII or giving them a choice in treatment; waiting months and in some cases years to tell people about positive HIV and hepatitis C tests; failing to get consent for research trials; and accepting incentives from pharmaceutical companies.

The pressures Prof Parapia cited include underfunding from the NHS, commercial pressure from pharmaceutical companies who marketed voraciously, and the availability of different brands of Factor VIII, including a shortage of the safer UK version.

Prof Parapia added that doctors who have been heavily criticised, including leading haemophilia adviser to the government Prof Arthur Bloom and  Dr Anthony Aronstam, head of the centre at Lord Mayor Treloar College, “were not bad people”.

“We didn’t have some sort of malevolent intentions against patients,” said Prof Parapia. “We had a choice of products and we tried to make the best decision at the time.”

Prof Tuddenham, echoed the concern. “People are on the edge at the Royal Free,” he said. “We’ll certainly come under some criticism, quite rightly. Some more than others.”

Ultimately, Prof Tuddenham expects the report to be “balanced”.

Colleagues at the Royal Free have suggested he step down over fears the General Medical Council could go after doctors for misfeasance. “No way, bring it on,” said Prof Tuddenham. “They just say that because I was there at the time and then I’ve spoken about what the situation was.”

Newcastle upon Tyne Hospitals and the Royal Free Hospital were approached for comment.